NPI 1710088711

Jeremy Shane Campbell, OD

Practitioner Optometrist Russellville, AL

Practice location

Address: 14378 Highway 43, Russellville, AL 35653-2568
Phone: (256) 332-1355
Fax: (256) 332-1315

Registered specialties

Optometrist Primary

Eye and Vision Services Providers Taxonomy 152W00000X Licence S-A80-TA-660 (AL)

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Registry record

NPI: 1710088711
Entity type: Individual
Sex (as registered): Male
NPI issued: 25 Sep 2006
Record last updated: 27 Oct 2010

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.